Patient Services Representative II, Hematology Oncology

Department:

13288 Wake Forest Baptist Medical Center - LC: Patient Access

Status:

Full time

Benefits Eligible:

Yes

Hours Per Week:

40

Schedule Details/Additional Information:

Monday thru Friday 8:30AM to 5:00PM

Pay Range

$21.45 - $32.20

EDUCATION/EXPERIENCE:

• High school diploma or equivalent and three years of experience working in a role within a customer service, fast paced environment with high volume of either calls or in-person requests; or an equivalent combination of education and experience

LICENSURE, CERTIFICATION, and/or REGISTRATION:

• N/A

ESSENTIAL FUNCTIONS:

• Interview patients in-person and/or by phone to obtain all required information for hospital records and billing systems.
• Pre-registers all scheduled patients for admission, partial hospitalization, and outpatient services according to department policies and procedures.
• Verify insurance coverage and obtains authorization for all services requiring pre-certification.
• Process internal and out-going referrals, as needed, per department procedures
• Perform clerical functions as needed, including answering phones, taking messages, chart processing, faxing and scanning.
• Collect and process upfront deposits or set-up payment arrangements, as required.
• Screen patient for Medicaid, Affordable care Act or hospital sponsored financial program and provides appropriate documentation and referral.
• Assist other team members where necessary
• Adhere to department policies and procedures related to verification of eligibility, benefits, pre-authorization requirements, available payment options, financial counseling and other identified financial clearance related duties
• Complete assigned registration functions within multi-specialty clinic and/or emergency department, which may include claim edit work queues, pre-certifications and authorizations.
• The Patient Services Representative II is expected to sequence multiple physician visits and complete registration activities within multiple registration platforms
• Assists team with escalated issues, trains other team members as needed and is a subject matter expert.
• Participate in departmental performance improvement initiatives
• Other duties as assigned or requested by Supervisor or Manager, such as acting as back up in other departments
• Understand and maintain operations knowledge of Medicare and other state and federal government payor compliance requirements for the population served.

SKILLS & QUALIFICATIONS

• EPIC Cadence experience preferred.
• Expert knowledge of patient access services and the overall effect on the revenue cycle.
• A thorough understanding of commercial and government insurance plans, payer networks, government resources and medical terminology.
• Understand and maintain operations knowledge of Medicare and other state and federal government payor compliance requirements for the population served.
• Demonstrated proficiency in communicating effectively with a customer and simplifying complex information.
• Demonstrated ability of critical thinking skills and adhering to compliance protocols.
• Demonstrated ability to handle escalated issues, train/mentor other team members and viewed as a subject matter expert.
• Ability to navigate Internet Explorer and Microsoft Office Suite of applications.
• Experience working in a role that requires prioritization of multiple critical priorities while ensuring quality and achievement of performance metrics.
• Demonstrated ability to meet or exceed performance metrics.
• Ability to handle sensitive information and maintain HIPAA compliance.

WORK ENVIRONMENT:

• Clean, indoor environment
• Minimal travel to clinic locations where assistance is needed

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
• Premium pay such as shift, on call, and more based on a teammate's job